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Consolidated Statements of Cash Flows - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2016
Dec. 31, 2015
Dec. 31, 2014
Cash flows from operating activities:      
Net loss $ (97,431) $ (35,762) $ (11,832)
Adjustments to reconcile net loss to cash provided by (used in) operating activities:      
Provision for doubtful accounts receivable 2,862 99 403
Share-based compensation expense 8,348 11,102 11,028
Depreciation and amortization 28,863 32,455 11,069
Amortization of deferred financing costs and debt discount 3,253 1,420 240
Amortization of (discount) premium on investments 11,373 301 1,593
(Gain) loss on sale or disposal of assets 2,362 170 816
Lease termination costs 179 1,185 0
Asset impairment expense 2,400 547 291
Loss on early extinguishment or restructuring of debt 0 0 11,969
(Income) loss from equity investees (10,768) 1,499 (3,050)
Impairment of investments 4,322 0 0
Realized (gain) loss on investments (2,528) 6,053 1,174
Net loss on contingent consideration (8,929) 0 0
Receipt of dividends from equity investees 8,723 4,647 2,081
Deferred income taxes 27,136 (13,102) (30,223)
Annuity benefits 8,962 0 0
Other operating activities (878) 5,451 (65)
Changes in assets and liabilities, net of acquisitions:      
Accounts receivable (55,907) (60,720) 18,349
Costs and recognized earnings in excess of billings on uncompleted contracts 24,529 (11,579) (1,139)
Inventory 2,220 2,610 6,616
Recoverable from reinsurers (1,947) 0 0
Accrued investment income (649) 0 0
Other assets 20,657 17,032 764
Life, accident and health reserves 56,338 608 0
Accounts payable and other current liabilities 11,905 36,216 18,968
Billings in excess of costs and recognized earnings on uncompleted contracts 21,643 (20,767) (23,793)
Pension liability (4,629) (10,638) (7,564)
Other liabilities (1,119) 3,259 (1,951)
Cash provided by (used in) operating activities: 79,148 (27,914) 5,744
Cash flows from investing activities:      
Purchases of property, plant and equipment (29,048) (21,324) (5,819)
Disposal of property, plant and equipment 8,824 5,034 3,706
Purchases of investments (239,941) (54,598) (33,034)
Sale of investments 89,392 12,248 2,411
Maturities and redemptions of investments 97,375 0 0
Cash from disposition of business, net of cash disposed 0 0 31,645
Cash paid for business acquisitions, net of cash acquired (66,346) 39,726 (146,026)
Change in restricted cash 44 0 (1,785)
Other investing activities (518) 0 0
Cash used in investing activities: (140,218) (18,914) (148,902)
Cash flows from financing activities:      
Proceeds from long-term obligations 56,058 54,042 374,815
Principal payments on long-term obligations (22,252) (19,287) (148,664)
Annuity receipts 3,399 78 0
Annuity surrenders (21,654) 0 0
Payment of fees on restructuring of debt 0 0 (12,333)
Proceeds from sale of preferred stock, net 0 14,033 40,050
Proceeds from sale of common stock, net 0 53,975 6,000
Purchase of noncontrolling interest (1,833) (475) (38,403)
Sale of noncontrolling interests 8,000 0 0
Change in restricted cash 0 6,014 0
Payment of dividends (4,220) (5,687) (1,626)
Net cash received for contingent consideration 2,335 0 0
Taxes paid in lieu of shares issued for share-based compensation (1,009) 0 (47)
Proceeds from the exercise of warrants and stock options 8 0 24,348
Other Financing activities (44) 0 0
Cash provided by financing activities: 18,788 102,693 244,140
Effects of exchange rate changes on cash and cash equivalents (971) (5,219) (2,001)
Net change in cash and cash equivalents (43,253) 50,646 98,981
Cash and cash equivalents, beginning of period 158,624 107,978 8,997
Cash and cash equivalents, end of period 115,371 158,624 107,978
Supplemental cash flow information:      
Cash paid for interest 39,193 39,451 7,527
Cash paid for taxes 20,859 1,134 8,792
Non-cash investing and financing activities:      
Purchases of property, plant and equipment under financing arrangements 0 1,808 4,400
Property, plant and equipment included in accounts payable 1,581 911 2,544
Investments in accounts payable 2,494 0 0
Reacquisition of shares from a noncontrolling interest 0 0 1,700
Conversion of preferred stock to common stock 28,534 1,839 0
Deemed dividend from conversion of preferred stock 6,867 0 0
Dividends payable to shareholders 1,322 1,005 777
Business acquisition through the issuance of common stock, long-term debt and warrants 0 11,591 0
Issuance of long-term debt 0 5,000 0
Fair value of contingent asset assumed in other acquisitions 2,992 0 0
Fair value of deferred liability assumed in other acquisitions 2,995 0 0
Debt assumed in acquisitions $ 20,813 $ 0 $ 0